- Humana (Indianapolis, IN)
- **Become a part of our caring community and help us put health first** The Utilization Management Registered Nurse 2 utilizes clinical nursing skills to ... independent determination of the appropriate courses of action. The Utilization Management Registered Nurse...skills to make an impact** **Required Qualifications** + **Licensed Registered Nurse ( RN )** in the… more
- Community Health Network (Indianapolis, IN)
- Registered Nurse ( RN ) Case Manager/ Utilization Review - North Emergency Job Ref 2408203 Category Nursing Job Family Case Manager Department Case ... Review position available in the Emergency Department. The Registered Nurse Case Manager is responsible for...inpatient and observation services. The RN Case Manager/ Utilization Review RN also assists… more
- McLaren Health Care (Indianapolis, IN)
- We are looking for a Utilization Management RN to join us in leading our organization forward. McLaren Integrated HMO Group (MIG), a division of McLaren ... Inc. at https://www.mdwise.org/ **Position** **Summary:** This position is responsible for utilization management functions. This includes but is not limited… more
- Fresenius Medical Center (Indianapolis, IN)
- **PURPOSE AND SCOPE:** The Inpatient Services Charge Nurse is an additional "responsibility" assigned to the Inpatient Services RN , for a limited period of time, ... duties, as assigned by the Program Manager. The Inpatient Services Charge Nurse ensures appropriate provision of Acute Dialysis Services and treatments within… more
- Fresenius Medical Center (Fishers, IN)
- …auditing activities. + Accountable for completion of the Annual Standing Order Review and Internal Classification of Disease (ICD) coding. + Manages clinic ... financials including efficient utilization of supplies or equipment and regular profits and...of supplies or equipment and regular profits and loss review . + Responsible for all required network reporting and… more
- CenterWell (Avon, IN)
- …license, auto insurance and reliable transportation. + Two years as a Registered Nurse with at least one-year of management experience in a home care, ... clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the...School of Nursing. + Current state license as a Registered Nurse . + Proof of current CPR.… more
- Highmark Health (Indianapolis, IN)
- …and Sunday required in addition to 3 weekdays** This job implements effective utilization management strategies including: review of appropriateness of ... and offers interventions and/or alternatives. **ESSENTIAL RESPONSIBILITIES** + Implement care management review processes that are consistent with established… more
- Sharecare (Indianapolis, IN)
- …appropriate total healthcare management and ensure cost effective, appropriate resource utilization and quality outcomes. The RN is also responsible for ... and their Primary Care Provider according to the disease management program intervention guidelines. An RN is...orientation and to take the pre and posttests to review competency during orientation. Yearly competency test is required… more
- Highmark Health (Indianapolis, IN)
- …Remote - Part Time - Weekends Required.** This job implements the effective utilization management strategies including: review of appropriateness of health ... and offers interventions and/or alternatives. **ESSENTIAL RESPONSIBILITIES:** + Implement care management review processes that are consistent with established… more
- Humana (Indianapolis, IN)
- …Family Therapist **(LMFT)** , Licensed Professional Counselor **(LPC)** , Psychologist **(PhD)** , Registered Nurse **( RN )** or other professional license. + ... us put health first** Humana Healthy Horizons in Kentucky is seeking a Utilization Management Behavioral Health Professional 2 who utilizes behavioral health… more
- Guardian Life (Indianapolis, IN)
- …services. Act as a liaison between all parties required in case management to facilitate collaboration toward RTW goals. Utilization of independent ... **Position Summary** The RN Clinical Consultant serves as a clinical resource...issues, when possible, to enhance the customer experience. **Activity** Review and assess claimant subjective reports and objective medical… more
- Ascension Health (Indianapolis, IN)
- …specialist for staff in the areas of utilization criteria, appeal and review process, and case management system documentation. + Develop staff schedule and ... Vincent Hospital + **Location:** Indianapolis, IN **MUST** have Case Management experience and a LCSW or RN ...Registration: One or more of the following required: + Registered Nurse credentialed from the Indiana Board… more
- Evolent (Indianapolis, IN)
- …Doing:** As a Clinical Reviewer, Nurse , you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference ... Clinical Reviewers are supported by Field Medical Directors (MDs) in the utilization management determination process. + Reviews charts and analyzes clinical… more
- ICW Group (Carmel, IN)
- …providing direct clinical care required. **CERTIFICATES, LICENSES, REGISTRATIONS** Current unrestricted Registered Nurse ( RN ) or Licensed Vocational ... + Interfaces with external agencies in relation to the utilization review process including, Third-Party Payers, Insurance...Nurse (LVN) required. Certification in case management , rehabilitation nursing or a related specialty is strongly… more
- Elevance Health (Indianapolis, IN)
- …or case management experience and requires a minimum of 2 years clinical, utilization review , or managed care experience; or any combination of education and ... CST or 8am - 5pm EST** The Med Mgmt Nurse is responsible for review of the...and nursing judgment and experience. + Collaborates with case management nurses on discharge planning, ensuring patient has appropriate… more